Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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SN109
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OSTOMY BAG WITH FTLTER COMBINATION
BACKGROUND OF THE IN'~ENTION
This invention relates generally to ostomy
bags, and more particularly to ostomy bags with
filters. Ostomy bags are usually secured to a pad
or surgical dressing which contacts the user's skin
and surrounds the stoma. Some patients have a
problem with emission of flatus gases and it has
been proposed to approach this problem by providing
colostomy bags with carbon filters secured to one
face of the bag over and around a gas outlet
aperture from the bag. The gas is then escaped
through this filter and the odors are reduced.
The problems are particularly acute, firstly
from the point of view of the positioning and
effectiveness of 'the filter, secondly from the
point of view of ease of manufacture of the bag,
and thirdly from the point of view of ease, comfort ,
and unobtrusiveness in wear, when the user is
unfortunate to have suffered an ileostomy operation
with the result that discharge usually has the form
of a relatively liquid slurry. In consequence,
choking of the filter is all too common. Filter
clogging is even more serious with drainable bags
which are intended for longer term use than closed
end non-drainable bags.
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SUMMARY OF TIE INVENTION
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According to the invention, there is provided
an ostomy bag having front and rear walls of a
thermoplastic film with the rear wall having a
stoma aperture. A filter is attached to one of the
walls over an opening in the wall through which
gases exit the bag. An intervening membrane is
located between the front and rear walls of the bag
l0 and is disposed between the stomal opening and the
filter, The intervening membrane is heat sealable
to the walls of the bag, and is microporous
allowing gas to flow through the membrane at a
substantial rate but being liquid impermeable. The
pore size of the membrane may range fram 0.1 micron
to 6 or more microns but is preferably between 0.2
and 0.5 microns. In one embodiment, the membrane
comprises a liquid impermeable, gas permeable layer
which, in the preferred embodiment, comprises a
fibrillated polytetrafloroethylene semipermeable
membrane. Qther gas porous membranes may be
created using interpenetrating network technology.
Also, the intervening membrane in the preferred
embodiment comprises a thermoplastic film layer
attached to at least one surface of the liquid
impermeable, gas permeable layer. Suitable
materials for the thermoplastic film are poly-
ethylene, polyester or a number.of the polyolefins.
The intervening membrane is relatively large
compared to the area of the filter surface, maybe
as much as five times as large or more, The
intervening membrane may be attached around the
periphery of the opening covered by the filter to
the interior surface of the wall to which the
filter is attached, or the intervening membrane may
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be attached to both the front and rear walls of the
bag along the top and side peripheries of the bag.
With the arrangement just described flatus
gases, but not the liquid-solid discharge, can pass
through the intervening membrane with the gases
being vented through the filter but the filter does
not become clogged with the liquid-solid discharge.
It is necessary in designing a filter
arrangement such as the one described herein, that
there be adequate air flow through the liquid
impermeable, gas permeable layer, otherwise, the
bag will tend to develop elevated gas pressure and
form an unsightly or uncomfortable bulge in the
bag. This is unacceptable. While it is mentioned
in some prior art references that a filter arrange-
ment could be designed to be liquid impermeable and
gas permeable, none that the inventor is aware of
have been disclosed in such detail as to teach one
how to make an acceptable filter membrane that
would provide an adequate rate of gas flow while
still maintaining an almost absolute impermeability '
to liquid discharge. In the intervening membrane
described herein, a gas flow of 100 cubic centi
meters (cc) per centimeter squared at at least 6
centimeters of water pressure in one minute is
obtainable. This relatively large rate of air
flow, while maintaining the liquid impermeability
of the barrier, is not to the inventor's knowledge
shown anywhere in the prior ostomy art. .
BRIEF DESCRIPTION OF THE DRAWINGS
The invention will be better understood from
the following non-limiting particular description
of embodiments thereof given with reference to the
accompanying drawings in which:
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Figure 1 is a rear view of a bottom emptying
ileosotomy bag according to an embodiment of 'the
invention;
Figure 2 is a front view of the bag of Figure
1;
Figure 3A is a cross-section through the
center of the bag on the lines and arrows 3A-3A in
Figure 1;
Figure 3B is an alternate embodiment of the
cross-section of Figure 3A;
Figure 4 is an alternate embodiment of the
front view of a bottom emptying ileostomy bag
according to an alternate embodiment of the
invention;
Figure 5 is a cross-section of the bag of
Figure 4 along the lines and arrows 5-5;
Figure 6 is a cross-section through part of
the wall of the ostomy bag containing a filter;
Figure 7 is an enlarged cross-sectional view
of the filter portion of Figure 6 showing its
laminated construction.
DETAILED DESCRIPTION OF THE DRAWINGS
Referring to the drawings, a drainable
collection bag designated generally 10 comprises
front and rear walls 12 and 14, respectively,
formed of a suitable synthetic plastics material.
The walls are welded together by a weld seam 15
around substantially the whole of their periphery.
The lower end of the bag narrows and ends in an
opening 20 which allows discharge of the material
collected in the bag.
A material suitable for use as the walls of
the bag should be gas and liquid impermeable. One
such material comprises a trilaminate of
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polyethylene vinyl acetate (EVA) copolymer on the
inner and outer laminates with a center layer of
polyvinylidene chloride (PVDC:) material. For the
sake of simplicity in the cross-sectional views of
Figures 3A, 3B and 5, the walls of the bag are
shown as a single layer. The trilaminate is
commercially available from W.R. Grace Co.
The rear wall of the bag comprises a stoma
aperture 22 adapted to receive the stoma of a
patient. The bag further comprises a first
coupling member 24 which is secured by heat welding
to the rear wall of the bag around the stoma
aperture 22. The coupling itself defines a stoma
aperture which aligns with the aperture 22 in the
bag. The stoma aperture, of course, need not be
circular but could be of any suitable shape.
The first coupling member 24 is of channel
shape seen in any radial cross-section, such as, in
Figure 3A, and has a radially inner wall 2f and a
radially outer wall 28. A second coupling member
(not shown) is also circular in shape and defines
an aperturelto receive the stoma of the patient.
The second coupling member is made of two parts,
preferably integral with each other, namely a
flange and a circular rib or projection which
cooperates with the channel shaped first coupling
member 24. The flange has a circular aperture and
is intended to be secured to a pad or a surgical
dressing which has a similar circular aperture and
whose opposite surface contacts the skin of the
patient. Details of the coupling members are
described in U.S. Patent No. 4,460,363 which is
hereby incorporated by reference as if specifically
set forth herein.
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The front wall of the bag comprises a small
gas venting aperture 30 which allows the interior
of the bag to be in communication with ambient
atmosphere. A circular filter 32 is attached to
the wall of the bag and covers the gas venting
aperture 30. The filter 32 in the Figures is shown
attached to the interior of the front wall of the
bag 10 over the gas venting aperture 30. The
filter 32 is attached with a layer of adhesive or
some suitable means to affix the filter to the bag
wall, the filter 32 being preferably a carbon
impregnated crushed polyurethane open cell foam or
equivalent.
The bag further comprises an intervening
membrane designated generally 40 which is located
between the front and rear walls of the bag in the
interior of the bag and is disposed between the
stomal aperture 22 and the filter 32 and the gas
venting aperture 30. The intervening membrane
comprises two layers laminated together comprising
a thermoplastic polymer film layer 42 which is heat
sealable to the walls of the bag, and a liquid
impermeable, gas permeable layer 44 which is
laminated to the thermoplastic polymer film layer.
A suitable thermoplastic film layer comprises poly-
ethylene or a polyester or other heat sealable
thermoplastic polymers such as those taken from the
class of polyolefins. The thermoplastic film layer
itself must be gas permeable. Thermoplastic film
layers which are themselves gas permeable to the
extent required for ostomy filter applications, are
also liquid permeable.
While the thermoplastic film layer must be
heat sealable to the bag walls) and gas permeable,
the other layer must be highly liquid impernneable,
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but gas permeable, allowing a sufficiently high
rate of gas flow therethrough which will be
acceptable to ostomates and not cause the bag to
collect gas and bulge. A suitable layer can be
formed from fibrillated polytetrafluoroethylene
(PTFE) in the form of a polytetrafluoroethylene
semipermeable membrane. This material is available
as Macroporous PTFE from Tetratec Corporation of
Feasterville, Pa. See U.S. patent 3,953,566 which
describes how to make tetrafluoroethylene polymers
of high porosity. Suitable gas permeable liquid
impermeable layers with adequate gas flow rates can
be made using interpenetrating network technology.
In Figures 2 and 3A the intervening membrane
40 is shown heat sealed by weld 46 to the periphery
of the bag at its top and along its sides. Because
the layer 44 is not heat sealed to the bag walls, a
perimeter strip of thermoplastic polymer material
45F the same as layer 42, is laminated to the
periphery of layer 44 where it is to be heat sealed
to the bag. Of course, a complete layer 47 of
thermoplastic polymer could be heat sealed on both
sides of the layer 44 when layer 44 is to be
attached along its upper and side peripheries to
the bag walls. See, for example, Figure 3B.
Intervening membrane 40 is heat sealed along its
bottom to the front wall 12 of the bag along the
weld line 48. The intervening membrane thus
encloses the filter 32 and separates it from the
stoma aperture 22 in a region in the upper part of
the bag 14. In the embodiment shown in Figure 3A,
the filter 32 and gas venting aperture 30 are
directly across from the stoma aperture. Because
the intervening membrane 40 is liquid impermeable,
but gas permeable, it will allow gas to pass
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through into the chamber surrounding the filter and
then through the filter and out of the bag through
the aperture 30, but it will not allow liquid or
solid waste to pass through and thereby clog the
filter 32. In Figure 3B, the intervening membrane
40 is shown unattached to either of the bag walls
along its bottom edge 50 but the membrane 40 is
still located intermediate 'the stoma aperture 22
and the filter 32.
Figures 4 and 5 show a third alternate
embodiment wherein the intervening membrane 52 is
generally circular in shape with a liquid and gas
permeable thermoplastic polymer layer 54 and a
liquid impermeable, gas permeable layer 56. The
membrane is heat sealed to the front wall of the
bag only around the filter 32 along circular weld
57. In this embodiment the intervening membrane is
not sealed to the periphery of the bag. This
necessitates only that the thermoplastic film 54 be
laminated to just one side of the layer 56.
Figures 6 and 7 show one embodiment for a
filter assembly to be used with the intervening
membrane 40. Referring first to Figure 7, a
preferred filter assembly 58 comprises a layer of
hot melt adhesive 60 whereby the filter may be
affixed to the wall of the bag; a layer of micro-
fine woven material 62; a matrix layer of hot
melted adhesive 64; a filter disk of carbon
impregnated crushed polyurtheane open cell foam 66
like the disc 32; a matrix layer of hot melt
adhesive 68; and a layer of non-woven fabric 70.
In addition to the intervening member 40, a
separate intervening wall 72 made of ethylene
butylacrylate which is a synthetic plastics
material may be included. This is shown not
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connected to the filter assembly 58, but connected
to the bag wall by a closed loop weld 7~ entirely
surrounding the filter assembly 58. The synthetic
plastics material will be needled at abaut 160
holes per square inch or between 100 and 300 holes
per square inch. The holes are preferably substan-
tially circular with. a maximum dimension of each
hole from 75 to 300 microns. This provides
additional protection against liquid penetration
but still allows adequate gas flow.
At least five different successful inter-
vening membrane configurations were assembled and
the air flow and water permeability tested. Each
of the configurations had an overall laminate
thickness of 3 mils and had excellent flexibility,
a critical requirement for use in ostomy bags.
Flexibility was measured by hand manipulation.
Each configuration was subjected to two water and
two airflow permeability tests. The two water
tests were a beaker test and a pouch test. In the
beaker test, approximately 150 cubic centimeters
(cc) of water was poured in a beaker and then the
membrane was tightly placed on top of the beaker.
The beaker was then turned upside down and water
permeability through the film was observed for five
minutes. In the pouch test, a pouch was prepared
with a membrane configuration as one wall of the
pouch. The pouch was then filled with water and
placed on a bench top with the membrane side of the
pouch at the bottom. hater absorbing non-woven
paper was placed on the bench top to observe water
leakage through the membrane.
The air permeability was measured using two
tests. The first follows the ASTM method D-726-58,
method A, and TAPPI Standard T460M49, using a
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Gurley densometer, model 4110. The second test is
an in-house pouch leak detecting test method. In
the in-house test, the pouch was prepared with one
side of the pouch made of usual pouch film and the
other side made from the intervening membrane
configuration. A flange on the pouch was attached
to a pouch leak detection apparatus and the pouch
was filled with approximately 400 cc of air until a
water manometer indicated 60 mm of pressure. The
air pressure inside the pouch was measured
throughout the test by a water manometer. The
pouch was then placed on a bench top and about 100
grams ring weight was placed on the pouch. The
ring weight is used to distribute the weight over a
larger pouch surface. A stop watch was started at
the same time. The time required for deflation of
the pouch was determined and the experiment was
discontinued when the pressure differential between
the inside of the pouch and the ambient atmosphere
reached 5.0 mm of water.
A 4-6 CFM PTFE film commercially available
from Tetratec using a Reemay 2250 polyester film
thermo-bonded to the PTFE film and a laminate
thickness of 3 mils was tested. The PTFE film had
a pore size of less than 1.0 micron. The term
"CFM" refers to air flow through the film in cubic
feet per minute per square foot as measured by the
ASTM Method F778-82. No water leaked through the
membrane in either of the water permeability tests.
The air flow of 300 cc through the intervening
membrane using the Gurley method took less than 1.6
seconds, while venting of the air in the pouch
using the in-house test took less than 15 minutes.
In a second configuration, a 10-12 CFM Tetratec
PTFE film with Reemay 2250 polyester thermobonded
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to the PTFE film was tested. This configuration
had a limiting pore size of 1.6 microns. Again no
water leakage was measured and the air flow of 300
cc was less than 0.9 seconds, while the in-house
method took less than 10 minutes. In a third
configuration, a 1.5 mil thick Tetratec PTFE film
of 0.45 micron pore size was thermobonded to a
non-woven fabric made from high density poly-
ethylene or polypropylene through a process of
extrusion, embossing and orientation. Frazier Air
Permeability of the high density polyethylene
non-woven fabric ranged between 1000 to 1200 cubic
feet/per minute/per square foot. The high density
polyethylene fabric, which is thermobonded to
Tetratec PTFE film, is commercially produced by
Applied Extrusion Technologies, Inc. of Middletown,
Delaware under the brand name DELNET non-woven
fabrics. Theoretically, any thermoplastic of the
polyolefin family with sufficient gas permeability
could be used for thermobonding. Again, no water
leakage was present and the air flow was less than
0.9 seconds using the Gurley method and less than
12 minutes with the in-house air permeability
method. A Tetratec PTFE layer was thermobonded to
a Reemay 2250 polyester film in a fifth configura-
tion in which the pore size of the PTFE layer was
0.22 microns. Again, similar results were obtained
as for the immediately above mentioned configura-
tion. There was no water permeability, air flow
took less than 0.9 seconds with the Gurley method
and less than 20 minutes with the in-house method.
Finally, a Tetratec PTFE layer with a pore size of
0.22 microns was thermobonded to a polyethylene
layer. Similar results were obtained.
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SIV109
In a configuration using a 25 CFM PTFE film
having an unknown pore size, the water permeability
was unacceptable probably due to very large pore
size. A Reemay 2301-1 polyester film thermobonded
to a Tetratec PTFE layer with an unknown pore size
was tested. The water permeability was acceptable
but the air flow through the layer using the Gurley
instrument method took 212 seconds.
In general, intervening membranes made from
commercially available PFTE, microporous, semi-
permeable film thermobonded to commercially
available gas permeable, polyethylene or polyester
' film provide for no water permeability and good air
permeability.
As can be seen from the Figures, the area of
the intervening membrane 40 is quite a bit larger
than the area of the filter 32 enclosing the gas
venting aperture 30. The area can be as much as
2-5 times larger than the area of the filter or
even larger. Because the area is so large and
because of the excellent air permeability of the
intervening membrane, gas will flow readily through
the intervening membrane and out the filter through
the gas venting aperture. If liquid or solid
discharge from the stoma does impinge on the
intervening membrane it will not remain long
because of the excellent surface tension
characteristics of the membrane. If some blockage
does occur, gas permeability will not be
substantially affected because the intervening
membrane is so large that the unblocked portion
will support adequate gas flow. Because no liquid
or solid passes through 'the intervening wall, there
is no blockage of the filter element which has been
a common and persistent problem in previous designs.
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To give an example of the increased
performance of this intervening membrane over
M
material such as MICROPORE microporous tape from
3M Company, which is somewhat gas porous but liquid
impermeable, at 6-10 centimeters (cm) of water
pressure the intervening membrane of this invention
will support an air flow rate of at least 100 cc
per cm2 per minute. A MICROPORE-like material
provides a rate less than 15 cc per cm2 per minute
at this pressure.
The intervening membrane of the present
invention also prevents gas absorption filter from
clogging by solid particles in the fecal matter,
thus maiwtaining gas odor absorption efficiency of
the filter.
